Latest News | Sep 7, 2020

The Week in Review in Prescription Drug Pricing

1. We’re Drug Pricing Voters

2. Paying Twice

3. Profiteering Poster Child

4. Made in Cali

5. “PhRMA lacks standing”

My name is Kolton Chapman and I live in Pickerington, Ohio. I am a transgender man living with a chronic illness. My life hasn’t always revolved around my illness –– I am an artist who enjoys coloring books and helping people design logos and other items to help with their businesses. I am a son who loves to spend time with his family, and I am an insurance agent. That last one is what I am most proud of. I have worked very hard to get to where I am today, and even with everything working against me, I was able to achieve my goals. I view every scar that I carry as proof that I have survived this long, and that it is going to take a lot more than that to break me.

In 2014, I was diagnosed with ulcerative colitis. After my diagnosis, I began taking Lialda to try and put my disease into remission. Just one month’s supply of that cost me $250, because there was no alternative drug available. That $250 was my cost even after what my insurance company covered. Two years in, I began receiving Entyvio infusions for my ulcerative colitis every four weeks. When I first began infusions, Entyvio was totally covered by my insurance. But I later had to change insurance coverage due to circumstances out of my control, and the price became astronomical. Every four weeks, I had to pay $1,200 per infusion under my new insurance.

At the time of this cost increase, I was in college and was already feeling the financial burden of student debt. Budgets for students are already tight enough, but the immense increase in cost for my infusions left me in an incredibly difficult position. Unfortunately with the added financial burden from my infusions, I had to choose between affording the cost of my infusions or school. This decision really wasn’t a decision at all since I needed the infusions to stay alive. The unreasonable price of my prescriptions forced me to leave college. 

Because of the astronomical cost of my Entyvio infusions, I now owe more in medical debt than I do in student loans. The massive financial burden from medical and student debt factors heavily into my decisions. I had to remove my colon, knowing that it was the only thing I could do to avoid more debt. Our medical decisions shouldn’t be driven by what will protect us from the most debt, but what will bring about the best health outcomes. 

In 2019, I was diagnosed with moyamoya disease, a rare blood vessel disorder, and have already suffered a stroke. My main priority through my health challenges should be focusing on my health –– not on bills and making ends meet. But unfortunately, with high prescription costs, their prices and my medical debt always factor into my decisions. Although I now have different coverage and am taking different prescriptions, I still spend over $150 per month on my four medications. This cost may seem more manageable compared to the $1,200 I was spending monthly on infusions before, but it’s still an incredible financial burden that is only being added on top of the remaining medical debt hanging over my head from earlier infusions. 

My life path has been completely altered by expensive prescription drugs and drug company greed. I often feel like I’m behind all of the people my age — even people younger than me — because I’ve had to focus my time and money on staying alive. We shouldn’t have to give up on pursuing a college education because of crippling medical debt. We shouldn’t have to make every financial decision with the cost of prescriptions and medical debt in the back of our minds. Things can be better if our leaders rein in drug companies’ greed and make the needs of patients like me the priority.

1. The Case of the Missing Executive Order  

2. There has been no “dramatic action” on drug pricing

3. Profiteering on a Pandemic

4. Wolves in Sheep’s Clothing

5. Crackdown Continues

My name is Denise and I’m from Ludington, Michigan. I was diagnosed with type 2 diabetes in 1995, and ever since I’ve been trying to figure out how to pay for all the medications I have to use to control the condition.

The first medication I tried was metformin, but in 2010, my blood sugar levels got to a point where I had to switch to Lantus. Though Lantus was working well for me, it wasn’t covered under my Medicare plan, so I was put on Novolin and an oral gliclazide.

A few years ago, my doctor wanted me to try Trulicity. It was incredible for my health — my blood sugar levels were always stable and within normal range. I could get up and do the things I wanted, and eating something sweet wouldn’t result in a spike.

However, Trulicity was more than I could afford. A month’s supply cost around $250, and it eventually threw me into the Medicare donut hole. I began relying on the Trulicity samples that the manufacturer sent to my doctor. But since the COVID-19 pandemic, there have been far fewer shipments of samples, and I haven’t been able to access Trulicity for months now.

Coming off of Trulicity has been so difficult — I gained 25 pounds in one month and felt hungry all the time. I’m back on Novolin and am still taking the gliclazide. While it costs just $50 a month now, it’s much harder to manage my diabetes. I struggle with my diet and the fluctuations in my blood sugar levels. It feels like my diabetic neuropathy has gotten worse — my legs and feet feel numb more often, and I’ve lost my balance and fallen a few times.

I get depressed because I can’t do the things I used to, and my life a year ago when I was taking Trulicity is so different from my life today. It’s hard to keep up with my grandkids because I can’t feel my feet, and the numbness in my body affects everything. I used to be very active and loved dancing and swimming, but now I can barely go up and down the stairs. When I go to the bathroom, I have to make sure my feet are planted before I take a step and map out everything I can hang onto.

If it weren’t for the cost, I would switch back to Trulicity in a heartbeat. But it’s hard to justify paying so much for one drug when my husband and I have to think about all the other medications we need as well, including those for high blood pressure, high cholesterol, restless leg syndrome, and seizure prevention.

I was a nurse for decades before retirement, and now I can’t access the drugs that I used to help provide for my patients. A few times, my husband and I couldn’t afford our groceries, and we had to go to the food bank in order to pay for our medications.

It’s hard to believe that with all of the advances in medicine, I still have to think about what I can and can’t afford instead of taking what works best. It seems like these medical advances are really for just the few — and Washington isn’t doing anything to help people like me.

WASHINGTON, DC – The drug lobby knows no shame. In the past 72 hours, drug corporations offered a flimsy plan. It’s not designed to lower drug prices for all Americans, but to stop the Trump administration from implementing its most-favored nation proposal. In response, Ben Wakana, the executive director of Patients For Affordable Drugs Now, issued the following statement:

“Big Pharma’s political stunt is exactly the kind of sorry excuse for a solution you would expect from drug corporations. It’s a PR move designed to block a better plan that would meaningfully lower drug prices. Patients have been promised real reforms to get Americans the best deal of any nation in the world and to lower drug prices by 50 percent. Instead, the drug lobby presented a plan that is voluntary, severely limited in scope, and impermanent.

“Patients resoundingly reject Big Pharma’s offer as an alternative to the most-favored nation plan. It’s too little, too late.”

BACKGROUND

###

WASHINGTON, DC – Today marks President Trump’s self-imposed deadline to advance an executive order for a most-favored nation approach to lower prescription drug prices. The president gave the pharmaceutical industry one month to propose a solution to meaningfully lower the list prices of drugs. Instead, drug corporations continued to raise prices and patients continued to struggle. It’s time for change.

“Abandoning the most-favored nation proposal at the 11th hour would be a capitulation to drug corporations,” said Ben Wakana, the executive director of Patients For Affordable Drugs Now. “If President Trump does not implement a proposal to lower the list prices of prescription drugs, he will leave Americans continuing to pay the highest prices in the world.”

Drug prices are not going down by “50%, 60%, maybe 70%” as the president has claimed. Instead, prescription drug prices continue to go up, even during a global pandemic. Pharma has had decades to propose its own solutions to lower drug prices, but with continued price hikes, the drug industry has proven it is unwilling to do so.

Americans overwhelmingly support proposals to lower drug prices by tying them to prices paid in other countries. By a 71-point margin, voters supported the Department of Health and Human Services’ ANPRM to lower drug prices in Medicare Part B by implementing an International Pricing Index. The most-favored nation approach is considered an outgrowth of that idea.

Comprehensive reform to lower the list price of prescription drugs for all Americans requires Congress and the president to come together to enact meaningful and sustainable policy change.

Nearly nine in 10 voters believe it is very important for Congress to lower drug prices, and almost one-third of U.S. adults consider a candidate’s position on lowering drug prices to be “the single most important issue” or “among the most important issues” that will influence their vote in 2020.

 ###

1. Moderna Sees Potential for Jackpot

2. Business as Usual

3. Acts of Desperation

4. Pervasive Profiteering

5. Pharma’s Statehouse Stampede

My name is Lija Greenseid, and I’m one of the thousands of parents whose children live with type 1 diabetes in the United States. When my daughter was first diagnosed, I was shocked –– first by the diagnosis itself and then by the economic cost that came with it. My daughter takes insulin, a drug that has increased by over 1000% in price over the past decade. We hit our insurance out-of-pocket limit for the year with just the first visit to the pharmacy to pick up my daughter’s diabetes medications and supplies. 

A few years after my daughter was diagnosed, I heard Nicole Smith-Holt talk about losing her son, Alec, after he rationed his insulin because of the price. I knew then that I needed to get involved. Nicole’s story was similar to other people’s stories, and I worried it could be mine too if someday my daughter couldn’t afford or access her insulin.

Four years ago, my family and I traveled around the world and bought insulin at one-tenth or less the price we paid at home. I grew frustrated thinking of all the families like mine who were paying unreasonably high prices for our insulin, and especially of the families like Nicole’s who had lost loved ones because of the price gouging on insulin. The United States is unique, in a bad way, in how expensive insulin is here. Other countries pay a fraction of what we pay for our insulin. I started sharing my story and took an active role in the fight for affordable insulin. 

Though I work part-time as a program evaluator, I began spending more and more of my time advocating for affordable drugs and health care changes. Living in Minnesota, just five hours from Canada, I and several other people with diabetes organized a cross-border trip to raise awareness of the unaffordability of insulin and to purchase the drug at one-tenth of the US price. There have been multiple of these “Caravans to Canada” trips and they have gained national media attention, pressuring elected officials and drug companies to acknowledge the unreasonable price gouging on insulin. Additionally, it brought attention to the thousands of people every year who travel to other countries just to afford their life-saving medications.

When it comes to cheaper insulin prices, Canada isn’t an outlier. Their prices could be our prices here in the United States. If our lawmakers allowed Medicare to negotiate with drug manufacturers as the Canadian public insurance does, the price would decrease significantly. We need lawmakers with the courage to prioritize patients and work to decrease the cost of prescription drugs like insulin. 

Because of our advocacy in Minnesota, some insurers in our state have capped their prices, allowing some people to only pay $25-30 a month for insulin. Additionally, we passed the Alec Smith Insulin Affordability Act which provides a safety net for Minnesotans who can’t afford their insulin. But this is not enough. Insulin is just one drug. We need solutions both at the state and national levels to address the system-wide greed of drug companies. Drug companies continue to charge ridiculous prices, further exacerbating already existing racial and economic inequities in our health care and prescription drug systems. High prices disproportionately affect black and brown communities, the same people hit hardest by the COVID-19 pandemic. In such a critical moment in our country, I’m inspired to refocus my activism and continue advocating for a more just system.